As political leaders discuss relaxing social distancing restrictions and opening up the economy again, a majority of Americans are concerned about whether it is safe to do so. They have fundamental questions about how the nation is doing, what will happen after it opens up, whether we will be able to keep people safe, and could we have to shut down again.
As we struggle our way through this, an essential element is missing: strong, effective leadership from the Centers for Disease Control and Prevention, the premier public health agency in the world.
Since the beginning of the Covid-19 pandemic, the CDC has been inexplicably absent, and Americans are suffering and dying for it.
The CDC has long been the steady, trusted source for high-quality national data and evidence-based guidance. But not this time, when its voice is needed the most.
While individual states oversee their public health departments, provision of health care, and actually implement policies and programs, the CDC has always provided the intellectual leadership, technical expertise, the expert guidance that states rely on to do their work. This federal agency coordinates efforts across states so they can learn from one another. And the CDC standardizes data and methods so we can get a true national picture of what is happening.
Want to know how many tuberculosis cases there were in the U.S. last year? Ask the CDC. Want to know about health-care-associated infections? Ask the CDC. It knows.
But ask how many Covid-19 tests have been done, and the CDC’s doesn’t have an answer. Want a daily update on how many people are getting hospitalized for Covid-19? The CDC isn’t tracking it. Want to know if social distancing is making a difference? The CDC doesn’t know.
During this pandemic, when accurate, timely, nationwide information is the lifeblood of our response, the CDC has largely disappeared.
The performance of the world’s leading public health agency has been surprising, and by that I mean surprisingly disappointing. When the outbreak began, the CDC decided to forgo using the World Health Organization’s testing kit for Covid-19 and build its own. The test it shipped out to states was faulty, creating problems that stretched for weeks and slowed response as states waited for replacement tests.
During this critical time, early hot spots like Washington state and New York City were unable to test for the virus. During the inexplicable number of weeks it took to figure out what went wrong, we could have easily adopted the WHO test, which was developed in Germany and is being successfully used in 126 countries around the world. This setback in testing — driven by defects in the CDC’s Covid-19 test and other bottlenecks and regulatory hurdles — is a major contributor to our national lockdown and the fact that thousands of Americans have needlessly died of this virus.
Beyond its testing failure, the CDC has been slow and its response inadequate in another area where it has always excelled: evidence-based guidance. Throughout this pandemic, it has been slow in coming, confusing, and not necessarily evidence-based.
The agency was slow to suggest that we should end large gatherings. As masks for health care workers became scarce, it recommended that health care workers wear bandanas and scarves with zero evidence that these would protect workers from the virus. Investigative reporting has uncovered unclear and disorganized communication to state public health agencies. And the CDC’s restrictive early testing guidelines did not necessarily align with what was understood about disease symptoms and risks at the time.
Americans rely on the CDC for evidence-based guidance. We have not received it.
Effective leadership from the CDC starts with immediately collecting standardized data and updating it regularly — including weekends. Yet for four weeks, the CDC took weekends off from reporting any data on the pandemic until overwhelming criticism forced it to change course. Daily CDC briefings would help the American public understand the data: Not only do we need to know the number of infections, tests, hospitalizations, deaths, and ICU cases, we need CDC experts to put these numbers in context, explain trends and outliers, and keep us grounded in science. Daily updates from the CDC would allow all of us to better understand how we are doing, whether we are likely to run out of hospital capacity and when, what the bottlenecks are on testing, and how we get ahead of this outbreak.
It would be easy for the CDC to do this, but it hasn’t.
Most states are already reporting some of this information every day, though often in haphazard and incomplete ways. The CDC’s natural role is working with states to standardize data collection and reporting it in a way that would make timely, important information publicly available.
It should also commit to providing guidance based solely on evidence, not speculation. If we run out of masks, the CDC should state clearly that going without masks is harmful (as the evidence suggests), not that we should wear makeshift bandanas (for which there is no evidence). Committing to evidence-based guidance would be easy, since it is what the CDC has historically done. And it would be immensely helpful at this moment.
During any public health crisis — especially the largest one of our generation — the nation’s top public health agency needs to provide leadership. That’s what the American people expect and deserve. But so far the CDC has been absent from the fray, and its absence is being felt.
This must be a painful time for the many extraordinary career scientists who continue to work at the agency. But it’s a painful moment for the American people, too, and with deadly consequences. Real CDC leadership — clear, science-based guidance, effective coordination of states, and public transparency of data — is absolutely essential for confronting and getting clear of this crisis.
The CDC was once the world’s greatest public health agency. We need that CDC back, and we need it now.
Ashish K. Jha, M.D., is director of the Harvard Global Health Institute and professor of global health at the Harvard T.H. Chan School of Public Health.
Not sure why nobody is taking me seriously, but if you look at the sea port cities and St.Lawrence seaway we are getting abnormally high counts of covid 19 compared to the rest of country. We of course need more testing, but shutting down the airline’s didn’t do enough. Commerce of world wide ocean shipping has brought major catastrophic events to our country. Just an example, cigarettes that come from China are located at every duty free store when you cross the border between Canada USA. Harvard medical studies have proven that the covid virus can survive in the nasal cavity for 21 days. As we know merchant marines don’t smoke. Sure… Essential workers don’t smoke,health care workers don’t smoke.. The covid remains in the nasal cavity for 21 freaking days so a carrier can infect hundreds of people without being aware of it. I smoke and I see how far smoke carries. Fortunately I have a great amount of social distance. All commercial products need to be sterile before they come off ships, because people handling it are passing on the virus.
Thank you for writing the article. We do need CDC to step up but I feel they are being purposely muzzled and watering down the seriousness of this pandemic. This is not a political virus, but we have a president who wants to create his Own reality and not the reality we are currently facing right
now! Obviously, social distancing is our only weapon. Look at the meat plants if you don’t think it matters! Over 60,000 people dead! Wake up! What are you not seeing?!!! Help us! CDC where are you?!!!!
Donald is Singlehandedly the head of the CDC and every other federal agency. They have all been corrupted by Donald. People at all the agencies below the corrupted top level think it is better to stay on the job rather than be a whistleblower. It takes courage to do the right thing… now more than ever.
Follow the money
Headline news in Newsweek claims Fauci promoted “gain of function” research into coronaviruses in the Wuhan.
I am wondering, is the gist of the article accurate?
The basic story is, Fauci favored “gain of function” and that can amount to creating a super virus.
The USA’s NIH – National Institute of Health, funded (not sure what % of funding, but about $550k per year) the virus institute in Wuhan to study coronaviruses from bats – and do gain of function research to try to make the discovered bat coronaviruses into better human pathogens, so that process could be studied and counteracted when a coronavirus emerged into the human population by natural mutations.
The statement from US govt. agency said the virus was not engineered in a lab but did NOT say the virus did not escape from a lab.
The claim was, many scientists opposed gain of function research for precisely what appears to have maybe occurred – you create a super virus and then it gets loose causing a pandemic.
The article states Obama admin. told NIH to stop and they put a moratorium on research, 2014, but then in 2017, Fauci (implied) got it started again. Says over 200 scientists had signed some kind of petition against it. When restarted, some kind of panel of experts was used to review studies to see if potential benefits outweighed risks, but that process (if followed at all) was kept entirely secret.
I have no idea if this is bogus or not. Newsweek, in fact all traditional powerful media companies IMHO, are no longer at all reliable – and it may be slanted badly – but seems possible Fauci/NIH/US/Wuhan/Chinese meddling may have caused this pandemic based on the article. Seems like kind of a big coincidence if the center of bat coronavirus research (I have no idea, maybe there is a comparable facility in every big city for all I know) but if it is a research center, what are odds pandemic just happens to begin there?
Anyone care to comment?
I find very few stories in Newsweek are adequately researched anymore – it’s click-bait. It might be shocking to learn that both NIH and DOD have active disease-agent research programs. Is it possible that Chinese researchers accidentally exposed a virus or bacterial agent to the population? Possible, but very unlikely. Researchers know all too well the danger their research presents for their own safety, and labs impose multiple safety measures for self-protection.
Those scientists are not designing biological weapons because nature provides an ample ambient supply of nasty infections. They are studying how they work and how to create treatments and vaccines against exposure. One biological agent, anthrax, was weaponized by Sadam Hussein. There was already a vaccine which the US developed to protect farm workers – those most likely to be exposed. That vaccine took over 7 years to develop. That is still the normal time to create a vaccine. Why does Dr. Fauci think we can develop one sooner? First, the infectiousness is so high that there is urgency. Second, we are diverting massive research attention – billions – at labs across the US to find a safe and effective vaccine. We cannot estimate how long it will take because this is the 1st undertaking of this scale ever attempted.
The CDC is a set of expert bureaucrats tracking biology trends. It must play two roles, both subservient to the statesman role our government must supply. First it must predict accurately the future and prepare for it (good luck with that!) and second, it must never be politically biased (good luck with that in our new idiotically polarized political environment propagated by biased educators and their insulated environments). The chance for the CDC to play a useful role against rapidly evolving societal phenomenon like SARS-CoV-2 is nearly impossible given its broad, shallow coverage of most issues. Given their structure, CDC cannot focus resources rapidly and effectively enough to be more than a sideshow. The NIH dominates.